Seroconversion following PPSV23 vaccination in children with type 1 diabetes mellitus

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-01-25 DOI:10.1016/j.vaccine.2024.126592

Elizabeth Ender , Avni Joshi , Melissa Snyder , Seema Kumar , Roland Hentz , Ana Creo

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引用次数: 0

Abstract

Objective

To evaluate whether children with type 1 diabetes mellitus (T1DM) have optimal humoral immune response to pneumococcal polysaccharide vaccination (PPSV23) and to study factors affecting that response.

Methods

In this prospective pilot study, we recruited 29 children with T1DM who were vaccine naïve to PPSV23 and assessed serum-serotype specific IgG at baseline and 4–6 weeks post-immunization. We tested association between independent variables (age, gender, body mass index (BMI), hemoglobin A1c (HbA1c), glucose variability, and time in range assessed by continuous glucose monitors (CGM), insulin dose and outcome (log-2-fold change of immunoassay response between pre- and post-immunization testing) using linear regression.

Results

Eighty-eight percent of children (22/25) who completed the study had overall appropriate response with a median 4.2-fold change following immunization. When assessing PPSV23-exclusive serotypes, there was a statistically significant correlation between increasing age and greater response (0.16 log2-fold change per year, 95 % CI (0.014 to 0.3), p = 0.033). Higher BMI for age (p = 0.085) and a lower coefficient of glucose variation from CGM following immunization (p = 0.067) also coincided with greater vaccine response, with correlation statistically significant for certain pneumococcal serotypes for both.

Conclusions

Response to pneumococcal vaccination has not previously been assessed in children with T1DM, and our study demonstrates robust humoral immune response to PPSV23 vaccination in these children. Larger studies with a diverse representation and longer follow up to assess how humoral seroconversion correlates with clinical response to PPSV23 in this vulnerable population are warranted.

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1型糖尿病儿童接种PPSV23疫苗后血清转化

目的评估 1 型糖尿病（T1DM）患儿接种肺炎球菌多糖疫苗（PPSV23）后是否具有最佳体液免疫反应，并研究影响这种反应的因素：在这项前瞻性试验研究中，我们招募了29名T1DM患儿，他们都是PPSV23疫苗的初接种者，并在基线和免疫后4-6周评估了血清血清型特异性IgG。我们使用线性回归法测试了自变量（年龄、性别、体重指数（BMI）、血红蛋白 A1c（HbA1c）、血糖变异性和连续血糖监测仪（CGM）评估的血糖在范围内的时间）、胰岛素剂量和结果（免疫测定反应在免疫前和免疫后测试之间的对数 2 倍变化）之间的关联：88%完成研究的儿童（22/25）总体反应适当，免疫接种后的中位数变化为 4.2 倍。在评估 PPSV23 专属血清型时，年龄越大，应答越强，两者之间存在统计学意义上的显著相关性（每年变化 0.16 log2 倍，95 % CI (0.014 to 0.3)，p = 0.033）。年龄越大，体重指数越高（p = 0.085），免疫接种后 CGM 得出的血糖变化系数越低（p = 0.067），疫苗反应也越大，两者之间的相关性在某些肺炎球菌血清型中具有统计学意义：我们的研究表明，这些儿童对接种 PPSV23 疫苗有很强的体液免疫反应。我们的研究表明，这些儿童对接种 PPSV23 疫苗有很强的体液免疫反应。我们有必要进行更大规模的研究，包括不同的代表性和更长时间的随访，以评估体液血清转换如何与这一易感人群对 PPSV23 的临床反应相关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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